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Portal venous varix

Case contributed by Raad Al Tahat
Diagnosis certain

Presentation

Abdominal pain.

Patient Data

Age: 25 years
Gender: Male
ct

Focal aneurysmal dilatation of the portal vein at its bifurcation. No filling defect. 

Abnormal elongation of left liver lobe crossing to the opposite side encompassing the spleen, consistent with beaver tail liver.

Right indirect inguinal hernia transmitting omentum, reaching the right scrotal neck.

There is an incidental abnormality of the bowel with right-sided small bowel (including D-J flexure) and left-sided large bowel. Appearances are of non-rotation.

Case Discussion

Radiological features are consistent with portal venous varix.

Portal venous varix is extremely rare; most patients are asymptomatic.

Diagnosis can be made when the portal vein exceeds 20 mm in diameter.

Incidental bowel non-rotation.

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